Alzheimer's care and service utilization: generating practice concepts from empirical findings and narratives.

Despite evidence of stress and strain, many of those who take care of relatives with Alzheimer's disease seem to resist using support services. Existing studies of the use of formal care by families of Alzheimer's sufferers are reviewed with special attention to findings relevant to access, particularly perceptions of appropriateness and acceptability or consistency with other needs and values. The conceptual model represented by these findings is then applied to a narrative that serves as a proxy for a real case that might confront a social worker. Viewed together, both the review of empirical findings and the narrative suggest that theoretical frameworks that take into account meanings attached to relationships and personal moral assessments of whether the duties of caregiving can or should be entrusted to others may offer promising alternatives to traditional psychological or psychoeconomic views of supportive service utilization.